银川市基层医疗机构抗菌药物使用情况对比分析
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摘要
目的对比分析银川市不同类型基层医疗机构抗菌药物使用情况,为加强基层医疗机构抗菌药物临床合理使用及有效监管提供参考依据。方法采用分层随机抽样法对银川市6个市、县(区)109家基层医疗机构2017年1-6月门诊处方抗菌药物的使用情况进行分析。结果诊所、社区卫生服务站、乡镇卫生院、村卫生室抗菌药物使用率分别为67.14%、30.67%、17.41%、18.60%,差异有统计学意义(P<0.05);诊所、乡镇卫生院、社区卫生服务站、村卫生室抗菌药物联用处方比例分别为25.41%、13.28%、9.53%、1.62%,差异有统计学意义(P<0.05)。诊所、社区卫生服务站、乡镇卫生院、村卫生室越级处方构成比分别为37.73%、2.40%、7.69%、6.26%,差异有统计学意义(P<0.05);无指征用药处方构成比分别为65.99%、82.60%、79.75%、84.36%,差异有统计学意义(P<0.05)。结论银川市诊所抗菌药物使用率、联用率及越级使用率均高于其他三类基层医疗机构,4类基层医疗机构抗菌药物无指征用药现象普遍存在,应加强基层医疗机构抗菌药物使用监管,尤其对诊所抗菌药物使用进行重点监管,规范基层医疗机构抗菌药物合理使用。
Objective To compare and analyze the usage of antibacterial drugs in different types of primary medical institutions in Yinchuan, it provides a reference for strengthening the rational usage and effective supervision of antibacterial drugs in the primary medical institutions.Methods A stratified random sampling method was used to analyze the usage of antibacterial drugs prescribed by the outpatient department of the 109 primary medical institutions in 6 districts of Yinchuan from January to June 2017.Results The rates of antibacterial drugs usage in the clinics, community health service stations, township health centers and village health clinics were 67.14%, 30.67%, 17.41% and 18.60% respectively, and the difference was statistically significant(P<0.05);There were 25.41%,13.28%, 9.53% and 1.62% prescriptions for the combined use of antibacterial drugs in the clinics, township health centers, community health service stations and village health clinics, with statistically significant differences(P<0.05);The rates of overstep antibacterial drugs prescriptions in clinics, community health service stations, township health centers and village health clinics were 37.73%,2.40%,7.69% and 6.26%,with statistically significant differences(P<0.05);The rates of antibacterial drugs prescriptions without medication indications were 65.99%, 82.60%,79.75% and 84.36%,with statistically significant differences(P<0.05).Conclusion The rate of antibacterial drugs usage, combined usage and overstep usage in clinics was higher than the other three kinds of primary medical institutions in Yinchuan. The antibacterial drugs prescriptions without medication indications in the four primary medical institutions were common. We should strengthen the supervision of antibacterial drugs usage in the primary medical institutions, especially in clinics, and standardize the rational usage of antibacterial drugs in the primary medical institutions.
Objective To compare and analyze the usage of antibacterial drugs in different types of primary medical institutions in Yinchuan, it provides a reference for strengthening the rational usage and effective supervision of antibacterial drugs in the primary medical institutions.Methods A stratified random sampling method was used to analyze the usage of antibacterial drugs prescribed by the outpatient department of the 109 primary medical institutions in 6 districts of Yinchuan from January to June 2017.Results The rates of antibacterial drugs usage in the clinics, community health service stations, township health centers and village health clinics were 67.14%, 30.67%, 17.41% and 18.60% respectively, and the difference was statistically significant(P<0.05);There were 25.41%,13.28%, 9.53% and 1.62% prescriptions for the combined use of antibacterial drugs in the clinics, township health centers, community health service stations and village health clinics, with statistically significant differences(P<0.05);The rates of overstep antibacterial drugs prescriptions in clinics, community health service stations, township health centers and village health clinics were 37.73%,2.40%,7.69% and 6.26%,with statistically significant differences(P<0.05);The rates of antibacterial drugs prescriptions without medication indications were 65.99%, 82.60%,79.75% and 84.36%,with statistically significant differences(P<0.05).Conclusion The rate of antibacterial drugs usage, combined usage and overstep usage in clinics was higher than the other three kinds of primary medical institutions in Yinchuan. The antibacterial drugs prescriptions without medication indications in the four primary medical institutions were common. We should strengthen the supervision of antibacterial drugs usage in the primary medical institutions, especially in clinics, and standardize the rational usage of antibacterial drugs in the primary medical institutions.
引文
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[14] 张莹,蒋艾豆,管玫,等.住院医嘱点评中抗菌药物不合理使用常见问题析评[J].中国抗生素杂志,2017,42(3):237-241.
[2] 国家卫生计生委规划与信息司.2014年我国卫生和计划生育事业统计公报[EP/OL].2015:10.
[3] Yin X,Song Fujian,Gong Yanhong,et al.A systematic review of antibiotic utilization in China[J].Journal of Antimicrobial Chemotherapy,2013,68(11):2445-2452.
[4] 刘玉平,张晓峰.抗生素滥用的危害及防范[J].中外医疗,2012,31(1):188-189.
[5] 杨旭东,孙玉凤,刘鸿宇,等.宁夏农村三级医疗机构门诊处方合理用药情况分析[J].中国社会医学杂志,2017,34(3):300-303.
[6] 董丽芳,高俊宏,颜虹.中国西部农村抗生素使用现状及其影响因素的两水平研究[J].中国卫生统计,2013,30(4):508-509,513.
[7] 叶丹,常捷,计文婧.陕西省基层医疗机构门诊抗菌药物使用情况分析[J].中国药事,2016,30(3):215-220.
[8] 王小平.抗菌药物在儿科治疗上呼吸道感染中的应用分析[J].北方药学杂志,2018,15(2):189-190.
[9] 饶春浓,温素玲.2015年我院门诊儿科用药分析[J].中国医院药学杂志,2016,36(8):438.
[10] 曾化松,王艳琳.抗生素滥用的现状及应对策略[J].中国卫生事业管理,2012,29(5):341-343.
[11] 林长军.某院抗菌药物使用情况分析[J].现代医药卫生,2013,29(14):2131-2133.
[12] 赵静,刘岚,温小军.贵州省北部某区农村基层医疗机构门诊抗菌药物使用情况调查[J].现代预防医学,2016,43(24):4477-4480.
[13] 何瑾,龙晓东,普燕芳,等.云南省乡村医生抗菌药物、糖皮质激素认知及使用情况的调查分析[J].中国药房,2016,27(3):299-302.
[14] 张莹,蒋艾豆,管玫,等.住院医嘱点评中抗菌药物不合理使用常见问题析评[J].中国抗生素杂志,2017,42(3):237-241.